Provider Demographics
NPI:1609121144
Name:PECULIAR HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:PECULIAR HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:FLORENCE
Authorized Official - Middle Name:O
Authorized Official - Last Name:NGWU
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE
Authorized Official - Phone:972-793-4932
Mailing Address - Street 1:441 FOREST RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019
Mailing Address - Country:US
Mailing Address - Phone:972-793-4932
Mailing Address - Fax:972-861-5542
Practice Address - Street 1:441 FOREST RIDGE DR
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019
Practice Address - Country:US
Practice Address - Phone:972-793-4932
Practice Address - Fax:972-861-5542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-20
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health